CA FAIR Plan Distribution Management


"*" indicates required fields

Please complete the below with the principal/owner's information. Questions may be directed to

Individual refers to a single registered person with the California Department of Insurance, or a sole proprietor.

Only complete this form if this is your first time registering with the FAIR Plan.
Agency Owner's First and Last Name:*
Please ensure this is the primary email address for the Agency Owner and not a distribution list.

Please fill in your complete business address below:

Please confirm the below:*
This field is for validation purposes and should be left unchanged.